2018 MIDTERM ELECTION

Time: D H M S

UPDATED: The Derp is Strong with Scott Gottlieb AGAIN (and yes, I'm taking the bait)

On Thursday, both Richard Mayhew and myself (as well as others via Twitter) thoroughly debunked American Enterprise Institute Fellow Scott Gottlieb (MD)'s incredibly misleading tweet about the number of ACA exchange enrollments.

Well, today he's decided to double down:

1.8% of the U.S. Population sign up for #Obamacare through Healthcare.Gov by the end of open enrollment; 6M Enrollees.

— Scott Gottlieb, MD (@ScottGottliebMD) December 20, 2015

Wow. The level of derp here is astonishing, and Gottlieb is clearly trolling, but what the hell:

  • In addition to the 6 million who have actively enrolled via HC.gov, over 1 million more have been confirmed to have enrolled via the state exchanges.
  • In addition, another 3 million or so more have almost certainly been automatically re-enrolled via HC.gov.
  • In addition, another 1-2 million more have almost certainly been enrolled (actively or automatically) via the state exchanges.

That, once again, is a good 11 million or more (potentially as high as 12 million) who have already been enrolled/re-enrolled to date, either actively or automatically.

So, you know, that 1.8% is actually likely more like 3.5% or so as of today.

Next up: "Open enrollment" has not ended whatsoever; it's only ended for January 1st coverage...and even then, only for most states (Massachusetts, Rhode Island and Washington State still have until Wednesday, while some residents of Colorado and Tennessee still have until New Year's Eve). Plus, there's up to 1 million people who could still potentially be enrolled in time for January coverage via HC.gov.

All that aside, of course, there's still 6 more weeks before the end of 2016's Open Enrollment period for people to enroll in coverage starting on either February 1st (12/18 - 1/15 in most states) or March 1st (1/16 - 1/31 in most states).

Obviously I have no idea how accurate or not my 14.7 million projection will end up being, but assuming I'm correct and that roughly 90% of those folks actually pay their premiums, that's 13.2 million people who'll be enrolled in effectuated ACA exchange policies for at least part of 2016...or over 4.1% of the total population. Even if you assume an end-of-year attrition down to around 12.2 million, that would still be 3.8%.

Hell, even if the end-of-year tally ends up being the HHS Dept's. likely-lowballed 10.0 million figure, that'd still be 3.1% of the U.S. population.

Is this number considerably less than the 21 million or so who the CBO was projecting earlier this year? Yes, it is...in large part because the 5 million or so people who the CBO thought would lose their EMPLOYER-based policies (and thus be "forced" onto the ACA exchanges) didn't happen. *doesn't appear to be happening. This is A GOOD THING.

Somehow I don't think Dr. Gottlieb will be tweeting about this issue after the auto-renewals are lumped in...but if he does, you can be sure that his tweets will be utterly full of crap in some other fashion.

*UPDATED to clarify: It's still too soon to tell what the net ESI coverage number for 2015 is.

UPDATE: In addition, of course, as mic08n64 notes in the comments, the ACA exchanges were never intended to enroll the entire population of the United States, for God's sake. Here's who you can't count as potential exchange enrollees:

Of course, there's a lot of overlap for some of thsoe groups (for instance, about 12 million people are enrolled in both Medicaid and Medicare), but when you subtract all of these folks, guess who that leaves? Potentially up to around 32 million people, give or take:

  • The 9 million who are already covered via ACA exchange policies
  • The 8 million who are already covered via off-exchange individual policies
  • About 7 million uninsured people who are eligible for ACA exchange tax credits
  • Around 3.5 million uninsured people who can enroll via the ACA exchanges at full price if they wish
  • Around 4.5 million uninsured

Based on that, the actual exchange enrollment rate is more like 35% of the potential eligible, give or take.

Now, you can certainly criticize the exchanges for only enrolling a bit more than 1/3 of their potential maximum....but 35% is still a hell of a lot more than 1.8%.